This article reviews current epidemiologic data on HS in diverse populations, including prevalence based on geography, age, gender, ethnicity, and details the spectrum of clinical features of hidradenitis suppurativa with discussion of disease severity and risk factors.

An integrated model of pathophysiology will be presented that considers possible abnormalities of the pilosebaceous-apocrine unit leading to an exaggerated immune response that may drive disease progression.

Hidradenitis suppurativa (HS) is associated with multiple comorbidities, including metabolic syndrome, smoking, depression, the follicular occlusion tetrad, genetic syndromes, malignancy, and autoimmune diseases (ie, inflammatory bowel disease (IBD), arthritis, and spondyloarthropathy). Additionally, due to the persistent inflammation and chronic nature of the disease, patients may experience a variety of other conditions that may be a result of the disease process itself (ie, depression, anxiety, anemia, and cardiovascular disease).

HS is a highly distressing condition that has one of the highest impacts on quality of life when compared to other dermatologic diseases like psoriasis, chronic urticaria, and atopic dermatitis. Patients with HS live with chronic, recurrent draining wounds that intermittently discharge pus and blood, cause odor and pain, and overall significantly decrease their quality of life.